The most advanced industrialized countries have shown 40−50% risk reductions in fatal occupational accidents and substantial reductions in the risk of occupational diseases during the past two decades. In spite of such success, the economic loss from occupational risks still amounts to 4−6% of GDPs, corresponding to at least one half of typical national health budgets (5–7). The declining trend in adverse occupational health outcomes among the best performers is continuing, despite the low levels of risk already achieved. This shows that there is no lowest limit in risk reduction (zero risk policy). Such zero risk policies are typical for the best economic performers who understand how to use ambitious occupational safety and health policies for both protecting the health of workers and improving productivity through better safety and health at work. Successful implementation of such national policies, strategies and programmes in practice needs close collaboration between sectors, including labour, health, social security, education, industry, agriculture and finance (1– 6, 30).
The risk of occupational injuries in advanced industrialized countries varies by one or two orders of magnitude between the lowest and highest risk occupations. The risk difference in contracting occupational disease is even wider. Highest risks are found in certain hazardous sectors such as mining, construction and agriculture, in small enterprises, among self-employed and informal workers, and, particularly, in developing and transitory countries (3). The vast majority
of the world’s 1 billion agricultural workers are without any OHS services. The ILO has developed innovative low-cost methods to fill the gap in service coverage (see Case study 7.1) (31).
On average, there is much evidence that small enterprises are at higher risk than larger enterprises for all accidents, fatal accidents and other hazards in both the industrialized and the developing world (32–34). In the EU15, a total of 82% of all occupational injuries and about 90% of all fatal accidents are registered in small and medium-sized enterprises (SMEs). Lack of sufficient competence and capacity to assess risks and manage chemical hazards and ergonomic problems means that the risk of occupational and work-related diseases has
Case study 7.1 Occupational safety and health (OSH) protection for grass- roots farmers in Viet Nam and the Philippines
Agriculture accounts for 63% of the total workforce in Viet Nam and 36% in the Philippines. Both countries show a need to enhance awareness on safety and health among farmers. The Work Improvement in Neighbourhood Development (WIND) programme in Viet Nam has trained many volunteers to extend practical OSH information and methods to grass- roots farmers. The training covers areas such as materials handling, work posture, machine and electrical safety, working environments, control of hazardous chemicals, and welfare facilities. WIND farmer volunteers train their neighbours by demonstrating existing good local examples. The ILO/ Japan Regional Programme for Capacity Building of Occupational Safety and Health (OSH) trained 480 WIND farmer volunteers in 14 selected Vietnamese provinces between 2004 and 2007.
In the Philippines, the Department of Agrarian Reform and Department of Labor and Employment are working together to provide WIND training to farmers. The Vietnamese and Philippine experiences with WIND have been shared with Cambodia, India, Lao People’s Democratic Republic, Nepal, Republic of Korea, Sri Lanka and Thailand. Countries in central Asia, Latin America, Africa and eastern Europe have increasingly been applying the programme. Three factors contributed to the success of this approach: (i) well-designed and validated methodology for training trainers using a training-by-doing approach, group learning and peer-training strategies applied in villagers’ own farms; (ii) interventions were low-cost solutions affordable for farmers; and (iii) involvement of volunteer villagers facilitated adjusting the methods to local conditions within a neighbourhood approach that generated trust and supported acceptance.
also been shown to be higher in small and medium enterprises, even when under-reporting is assumed to be substantial. Conversely, closer interaction and social relations within small working units means that smaller enterprises are reported to have better psychosocial conditions of work. Small enterprises have become the only sector with increasing net employment and therefore virtually all advanced economies have given high priority to promoting their generation. It is important to integrate strong safety and health programmes within such development strategies – for example, by making decent work, safety and health a condition for public development support (33–38).
The globalization process leads big enterprises to merge, thereby growing larger and fewer. Although there are only 63 000 (0.04% of world total) large multinational enterprises worldwide, employing 86 million workers (0.27% of world total), they produce substantial amounts of their products through smaller subcontractors and control 70% of world trade. They have great opportunities for serving as models for decent work practices in their own and subcontractor settings. Simultaneously, new economic and enterprise structures are emerging, with a growing trend in numbers of micro, small and medium-sized enterprises and self-employment. About 90% of enterprises are small, employing fewer than 50 workers. The formal micro, small and medium-sized enterprises employ about one third of the world workforce. Several types of subcontracting and other partnership relations and networks are formed between the SMEs and big companies. The majority of workers in developing countries work in small enterprises or are self-employed in the agriculture, domestic work and informal sectors (33–38). Together with ASEAN governments, the ILO has successfully experimented with a new approach – Work Improvement for Safe Home (WISH) – for practical actions for improvement of working conditions for home workers and the informal sector (see Case study 7.2) (39).
A new global trend detaching the financial sector from the real economy has resulted in a continuing financial crisis. Severe injuries to economies have had a dramatic impact on workers’ situation through constriction of the labour market, loss of jobs, growing unemployment and lower quality jobs. In turn, these have exacerbated longstanding problems related to poverty and are widening inequality among working people, particularly young and vulnerable workers. Devaluation of human work has become a global trend, with a tendency to lower salaries and social protection, and international organizations and national governments struggle for crisis management with only modest success (40). Long-term predictions based on experience from past financial crises point to increasing insecurity and unemployment associated with health problems such as elevated total morbidity and mortality in cardiovascular and mental health disorders (depression, suicides) among working populations. These are likely
Case study 7.2 Participatory approaches to improving safety, health and working conditions in informal economy workplaces in south-east Asia
Throughout Asia, 60% of the workforce is informal, lacking access to formal safety and health services. Hence, the Association of Southeast Asian Nations (ASEAN) faces an increasingly important challenge to provide adequate OSH protection to informal economy workplaces such as homes, small construction sites and rural farms. Informal-economy workers are often exposed to chemical, physical and ergonomic workplace hazards without being aware of the health risks. Such workplaces often lie outside the scope of OSH legislative frameworks, making it difficult for government inspectors to reach them. In addition, accidents and diseases are seldom reported to the government. Participatory training programmes to improve OSH have provided practical means to address these issues, and are increasingly applied in informal enterprises.
WISH is a typical participatory training programme. Designed for home workers and small businesses, WISH training encourages participating home workers to apply an action checklist with illustrated “good examples”, learn to recognize OSH risks at work and to seek low-cost, quick solutions. Wherever possible, local good practices are presented as workable solutions. The WISH programme focuses on five technical areas: (i) materials handling; (ii) workstations; (iii) physical environment; (iv) machine and electrical safety; and (v) welfare facilities. Improvements in these technical areas contribute substantially to safety, health and productivity. Participatory training programmes have been incorporated into national OSH programmes and policies. With technical cooperation from the ILO’s Informal Economy, Poverty and Employment project, government inspectors in Cambodia have worked collaboratively with local trade unions, employers’ organizations and NGOs to train their representatives as participatory OSH trainers. Through local networks, trainers frequently visit home workplaces, small construction sites and small farms to provide on-site OSH training. Rural villages, some without electricity, have participated in this practical OSH training and subsequently implemented improvements in safety, health and productivity. With national support and strengthened networks, these practical programmes are gradually expanding their reach into more informal-economy workplaces. Success factors for these concrete work environment interventions to fill the implementation gap among underserved and vulnerable workers include the: (i) availability of ILO technical assistance; (ii) ILO staff’s long experience of developing methods for participatory training; and (iii) target constituents’ interest in participating.
to be seen for several years, possibly up to a decade (29). Actions for better international and national governance and regulation of financial sectors; more accountable and transparent financial practices; fair distribution of financial risks to their creators; and better protection of workers and vulnerable people in times of crisis are proposed as ways to tackle the crisis (29, 40–42). In times of crisis, there is a risk of compromising the quality of employment, safety and health. Most occupational fatalities occur in developing countries and countries in transition, where capacities for control and management of risks are less developed. The working populations of the least developed countries and advanced industrialized countries show a difference of three orders of magnitude for occupational accident risk.
The current estimate suggests that there are 1.6 billion informal-economy workers comprising 50−60% of the world workforce. Precise numbers are not available due to the special dynamics of ‘informalization’, poor monitoring, lack of registration and statistics and the fact that some informal work is illegal in many countries. Protection for these highly vulnerable workers requires action from the employment sector and social policies for ‘formalization’, i.e. registration and full coverage by labour, safety and health legislation, social protection, and OHS services (4, 19, 21, 22).